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Opioids Doc Wants to Switch Me to Methadone - Terrible Idea?

^^

It depends on what dose you are on. If your tolerance isn't that high for opiates and you're given a decent size dose of methadone, you're going to get pretty rocked. A lot of people just sleep all bloody day because they are on way too much.

The right dose will keep your withdrawals away, give you a slight warmth, take away any cravings for other opiates, and allow you to still function/stay awake like you normally would.
 
Mr.Scagnattie said:
^^

It depends on what dose you are on. If your tolerance isn't that high for opiates and you're given a decent size dose of methadone, you're going to get pretty rocked. A lot of people just sleep all bloody day because they are on way too much.

The right dose will keep your withdrawals away, give you a slight warmth, take away any cravings for other opiates, and allow you to still function/stay awake like you normally would.
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Gotcha. I just realized the script my doctor wrote can actually be filled tomorrow, so I'm going to abstain from the oxy and give it a shot.
 
I wanted to post an update since I tried the methadone today.

I took 15 mg about 3 hours ago. Based on what I'd read, I wasn't expecting to notice any effects for an hour or so, but to my surprise I started feeling it after about 20 minutes. The effects were far more pronounced than I expected. Initially it made me feel pretty intoxicated....more like I was stoned and had smoked pot rather than what I normally experience with opiates. That subsided after about an hour and I was left with a more familiar opiate buzz, but still noticeably different. Normally oxy and hydro diminish after about an hour, but it's been 3 hours now and it has just started to slow down. Unfortunately for pain relief, it didn't seem to help much as my pain is still pretty bad. I understand that you have to take methadone for several days before you feel its full effects, so maybe it will offer better analgesia with time.

A fairly pleasant experience and pretty far from what I expected. As I said, it was more intoxicating and not nearly as smooth as what I'm used to with oxy. Oxy and previously hydro normally make me feel sharper and more focused, while the 'done had the opposite effect. I'm glad I tried it on a weekend, as I think it would be pretty difficult to work with due to the cloudiness it made me feel. At least from this initial test, the pain relief isn't anywhere what I need and get from the oxy. My preference would be to stick with the oxy, but try to cut back on my dosage over the next few months so that it's at a more manageable level. I'm going to propose that to my doctor, but I expect he won't be on board. Hopefully he will at least agree to give me a few weeks of meds so that I can find a new doc. Otherwise I guess I will continue with the methadone until then.
 
Harrisment said:
This is very encouraging. What impact did it have on you from an energy standpoint? I've heard some say that is gives them that social opiate feeling of all is right with the world all day, while others say it turns them into a zombie that doesn't want to leave the house.
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Well I react well to any opiate, whether natural or synthetic. I have always gained energy and motivation using opiates so I don't know if that's typical of most users or not. I was most certainly not a zombie, I felt really good. When they suggested putting me on methadone, I said that if I didn't like it, I was going back on my previous medication (dihydrocodeine) but that turned out to be unnecessary. It gave me more control over my doses because of it's long acting effect, I wasn't craving more. It also was a really good pain killer for me. I actually felt a lot better on it than I did with my other med, probably because it was so much more stable. Of course what works for one, may not work for another. I was never a heroin user so I don't know what it's like to go from that to methadone, just from dihydrocodeine to methadone. Some hate methadone, some do really well on it. All I can say is it won't hurt to at least try it because you'd never know otherwise.
 
Yeah everybody is different. I wasn't taking oxy, I was taking something less potent (but at a very high dose) when I went on methadone, for me it felt like a couple steps up. However, I definitely would give it some time to stabilize on the methadone. You say it's more intoxicating than oxy, but not good for the pain, so maybe it's not a dosing issue. You could find once it builds up the pain control might be better, if not I would make sure your doctor is giving you the right dose, the dose of methadone that is equivalent to your dose of oxy. I was taking 30 dihydrocodeine tablets a day, at 30mg a tablet (yeah that's a lot, took me many years to get that high in my doses). That turned out to be equal to 30mg of methadone, because obviously methadone is a lot stronger than dihydrocodeine.

When I had my second dose, I felt even better and so on. After a few days it leveled off. Hopefully after a few days you'll find it helps more with pain. If not, I would make sure you're on the right dose, failing that maybe you need to do this with oxy, but unfortunately no matter what med you try to taper down, if you have unresolved pain issues, you're going to find it will stop working on the pain after a while. What is your doctor's goal, really? To lower your doses and sustain you on that or get you off completely?
 
I think you need a new doctor.

Methadone at that dose was not equivalent to your other previous pain meds - which is why your pain is not properly controlled now. Methadone gets into the bones literally and as the dose increases, will be far harder to detox from than short half life opiates.

I disagree categorically with the poster who labelled you an addict just using pain to seek drugs. Chronic pain patients get enough of that erroneous nonsense from ill-educated medics, let alone getting it here. No one is an addict until they say they are. It is easy for a non-medically trained poster to sit at a keyboard and label pain patients they never even met as addicts - let's hope they never have to experience and endure intractable chronic pain AND try to keep a roof and put food on the table.

In terms of long term opiates for chronic pain, they can increase the pain levels/pain timings - I urge you to research opioid induced hyperalgesia. I came off a huge dose of pain meds previously that were still not controlling my pain and after detox, my pain level reduced significantly and stayed manageable for several years.
 
projump2001 said:
Your doctor might save your life.. Consider giving it a chance.. The pain you talk about is just you finding reasons for continuing down this road, just keeping it real ..
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How is this helpful? It certainly is not "keeping it real".

There is a world of difference between a genuine pain patient needing pain meds for pain management and an addict that abuses drugs to get high/maintain addiction. Not everyone using opiate pain meds is doing so to abuse them - they are used in clinical settings for severe pain for a reason!

You know nothing about the OP's medical history, pain levels or daily struggles to retain employment and manage severe chronic pain.

Judging legitimate pain patients as addicts is bad enough when done by ill-educated doctors putting their own agendas above their patients', let alone non-medics, on a forum, labelling someone they never even met, whom is in pain, as an addict seeking drugs. This is despicable behaviour. No one is an addict until they say they are, not you. Not everyone is making up pain to seek drugs.

I genuinely hope you never experience intractable chronic pain, whereby these meds are a necessity to function, not a choice. Most pain patients do not even want to be on these meds and would give anything to be pain free and are not on these meds for a laugh or to abuse them. Until you have been in someone else's shoes, do not judge them. Karma is a powerful entity my friend.

There but for the grace of luck, go you. Let me tell you from personal experience, poorly managed pain can take people to dark, dark places. Let's hope you never have to find out how that feels. None of us know what is around the corner...
 
OwnedByCats said:
What is your doctor's goal, really? To lower your doses and sustain you on that or get you off completely?
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His goal is to get me completely off of meds, and get a pump surgically implanted to deliver my pain meds in the future. As I said, this is a new doctor that I've only been seeing for a short time. I haven't done much research yet on the pump option, but what little I do know doesn't make it sound like something I am ready for. My pain has been fairly well controlled over the past few years through a combo of oral opiates and spinal injections a few times a year.

I tried the methadone again this morning (10 mg), and it once again made me feel totally spaced out and gave no pain relief.
 
Harrisment said:
His goal is to get me completely off of meds, and get a pump surgically implanted to deliver my pain meds in the future. As I said, this is a new doctor that I've only been seeing for a short time. I haven't done much research yet on the pump option, but what little I do know doesn't make it sound like something I am ready for. My pain has been fairly well controlled over the past few years through a combo of oral opiates and spinal injections a few times a year.

I tried the methadone again this morning (10 mg), and it once again made me feel totally spaced out and gave no pain relief.
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The pump, i.e. intrathecal med delivery is really supposed to for patients that don't respond to large doses of opiates, not for patients on stable oral doses. I'd wonder is your doctor on some kind of kickback for these devices?

Either way, as the methadone is not controlling your pain, it will need to be reviewed - I'd insist in being prescribed the previous medications that worked. Why he decided to tamper with something that was stable and working is inexplicable other than he is putting his own interests ahead of his patient's.
 
There's a few ppl at my clinic almost at 750-850mg of methadone. I would choose fent patches over methadone any day. BTW the clinic I go to is a private one, so they're in it for the $$$
 
^ right thats awful god awful. a dose like that has to have some real negative side effects. wonder what the patient would do if it got shut down and they were forced to return to even close to a normal dose. Not judging anyone but the place is shady as shit.. just hooking people and giving them so little chance at ever getting out.
 
Harrisment said:
His goal is to get me completely off of meds, and get a pump surgically implanted to deliver my pain meds in the future. As I said, this is a new doctor that I've only been seeing for a short time. I haven't done much research yet on the pump option, but what little I do know doesn't make it sound like something I am ready for. My pain has been fairly well controlled over the past few years through a combo of oral opiates and spinal injections a few times a year.

I tried the methadone again this morning (10 mg), and it once again made me feel totally spaced out and gave no pain relief.
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Yeah that seems a bit extreme to me really. If your pain is controlled with oxy, plus your injections, I don't get why you need a pump. I just think that's unnecessary right now. How long have you been on a sustained dose of oxy?

I'm sorry the methadone seems to not help with pain. My chronic pain was headaches and any time I was on an optimum dose of any kind of opiate, I rarely even got them. Of course I've been off opiates for almost 6 years and I have headaches every day. Unfortunately where I live now, nobody wants to give me opiates to treat this type of chronic pain because well, I could be faking it, right? Seeing as how no cause can be found, they just don't care if my quality of life is completely the worst it's ever been. Admittedly I have not seen a pain management doctor, but I was never even referred to one. Not by PCP or neurologist. They just seemed to give up on me.

If possible, I would see about finding another doctor. One thing he should be doing is taking into consideration what works for you. I know not all do that, but they should. The spaced out feeling should pass, but what good is it if the pain control is non existent? Right now it's only function is keeping you from withdrawals from oxy.
 
m3trigun said:
There's a few ppl at my clinic almost at 750-850mg of methadone. I would choose fent patches over methadone any day. BTW the clinic I go to is a private one, so they're in it for the $$$
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Yikes, that's crazy! I wonder if they started at that amount, or this is after a few increases ...
 
Harrisment said:
His goal is to get me completely off of meds, and get a pump surgically implanted to deliver my pain meds in the future. As I said, this is a new doctor that I've only been seeing for a short time. I haven't done much research yet on the pump option, but what little I do know doesn't make it sound like something I am ready for. My pain has been fairly well controlled over the past few years through a combo of oral opiates and spinal injections a few times a year.

I tried the methadone again this morning (10 mg), and it once again made me feel totally spaced out and gave no pain relief.
Click to expand...


Oh oh I also meant to say, someone did mention maybe this dose wasn't enough for you. It certainly might explain why it's not helping with pain.
 
Yup I'm dead serious, at my clinic they start you around 30-60mg and its very easy to get a dose increase, they want you to be on a "comfortable" dose.
 
I saw my doctor and to my surprise he was really understanding. He ended up prescribing me another month of the oxy, and he is on board with me trying to slowly reduce my dosage of it rather than forcing me to stay on the methadone. Ultimately I would like to be able to control my pain with less medication, so I'm pretty optimistic that this is a good first step. I think my frustration and the pain I was in was pretty clear, as it's the first time I've really felt compassion from this particular doc. A very unexpected and pleasant surprise, as I went in there fully intending to say I was moving on to search for a new doctor.

Huge thanks for all that shared their experiences and opinions in this thread. It's been incredibly helpful.
 
Great news. Thanks for the update.

As you are considering a reduction, please do research "opioid induced hyperalgesia" - the phenomenon whereby increased opiate use actually potentiates an increase in chronic pain.
 
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